Overcoming Infertility: What You Should Know Before Trying Clomid
In the second of three installments on overcoming infertility, watch Dr. Rami Kaldas discuss Clomid and why it might not be right for you.
Clomid is a popular and often the first potential treatment offered to patients dealing with infertility. Primary care physicians and OB-GYNs often prescribe it before referring patients to a fertility specialist. But the thing is, Clomid impacts ovulation. If you're struggling to get pregnant for any other reason, it's not likely to help you, which is why you should figure out what you're facing before pursuing any specific treatment, even Clomid.
Watch Dr. Rami Kaldas explain the origins of Clomid and why it's essential to dig deeper into your specific fertility challenges before trying it.
Explore more fertility topics here.
Video Transcript
Dr. Rami Kaldas: Let's say someone has tubal occlusion, and most everyone that I see that's been placed on Clomid hasn't been checked to see if their tubes are open even. And with having whether endometriosis or not, you need to kind of do that, you know, because you just need to go through the basic steps of eliminating the unknown variables as causes. And it can take - it's very quick, it's a very efficient process. And then directing the patient to the appropriate, the correct, therapy because one size does not fit all. And so Clomid, in fact, is actually an anti-estrogen, is a selective estrogen receptor binder. And so estrogen molecules can't see the target tissue, the target cells, when Clomid binds to it.
So what happens is the brain thinks, oh, there's a low estrogen environment, and the brain makes more follicle-stimulating hormone, and then that makes more eggs happen, more follicles, more eggs. So you end up with a ten percent risk of twins, about a one percent chance of triplets with Clomid. It's been around since the late fifties. It was actually, we were looking at the University of California in San Francisco. They were looking for the contraceptive pill, and they thought this Clomid, you know, this chemical preparation - that's promising, it's anti-estrogen. That would be a good contraceptive pill. And then they found out, oh, my God, people are getting pregnant on it more. So they kept on looking, and they came up with the contraceptive pill a few years later. And back in late and mid to late sixties and but anyway, and so Clomid, you know, it can actually thin the lining because it binds the estrogen receptors in the lining of the uterus and it causes it to become more thin. If a lack of ovulation is not the reason that you are not becoming pregnant, Clomid can have a negative impact. Okay, because if you just give Clomid alone, your chance of pregnancy are about seven percent per month, okay, with timed intercourse. And, and the baseline rate for fertility is around twenty percent for a normal infertile couple. Okay? Twenty to twenty-five percent at most for a normally fertile couple any given month if they're timing it just right. So if they have no ovulatory issues and you throw Clomid at them, it's not necessarily going to make things better.
There's a negative component. It's like, you know, giving, giving two birds and taking one back, okay? And robbing Peter to pay Paul is another way of saying it. And, and so it is appropriate for many people but not for every person is what I'm saying. But no one is taking the time or effort to figure it out. Not no one, but, you know, this is the clientele that's coming to us, and so it's kind of a funny thing and a funny that the interesting thing is people don't realize that the reason that the, one of the big reasons that the success for pregnancy, even when a normally fertile couple is timing just right in their twenties, is because of all human conceptions something like two-thirds of them are genetically different and will not implant.
And so, even though you've conceived, you're actually not going to be pregnant. You will not have a late period. Why one minute you will not have a positive pregnancy test because that conception never implanted because it is genetically different, and that's that. So therefore, right off the bat, that's one of the biggest reasons that people don't get quote-unquote pregnant any given month when their timing is just right because they've already got the tables tilted against them two-thirds right. And so you end up with twenty, twenty-five percent at best, any given month.